Helping identify and care for infants and their parents, caregivers, and families

Children and Family Futures (CFF) provides training and technical assistance to tribes, states, counties, and community agencies to improve outcomes for pregnant and postpartum women, their infants and family members affected by prenatal substance exposure. Resources focus on optimal bonding, health, and well-being and assistance includes:

  • Resources and education on best practices related to the treatment and care of infants, parents and their families affected by substance use
  • Development of tools for collaboration and integrated case planning across the service continuum, including Plans of Safe Care required by federal legislation
  • Review of tools, practice guidelines, and policy related to infants with prenatal substance exposure, their parents and family members providing insight from the fields of substance use disorder treatment, health care, child welfare, and early intervention
  • Connections to experts and peers across the country to share what is working in their fields and jurisdictions

Prenatal exposure to alcohol, tobacco, and drugs may cause a spectrum of physical and developmental challenges related to growth, behavior, cognition, executive functioning, language, and achievement.1  Infants with prenatal exposure to opioids may experience Neonatal Abstinence Syndrome, a treatable pattern of effects that are associated with opioid withdrawal in newborns. In combination with other safety and risk factors, prenatal exposure can have implications for child welfare services involvement. A range of prevention, early intervention, and treatment efforts can mitigate negative outcomes for these infants, parents and their families. Examples of these strategies include early identification and engagement of pregnant women with SUDs in treatment and services, collaborative development and implementation of a Plan of Safe Care for the infant and family/caregiver, and early engagement into developmental services for identified infants and children. The intersection of pregnancy and substance use creates a need for a collaborative approach that brings health, substance use treatment, child welfare, and early childhood providers together to identify and provide intervention for the multifaceted needs of infants, parents, caregivers, and family members.


CFF has disseminated over 10,000 materials related to infants with prenatal substance exposure since 2016
CFF has responded to over 4,700 technical assistance requests on infants with prenatal substance exposure since 2016


38,625 infants in 47 states were referred to child welfare services as infants with prenatal substance exposure in 20192
48.6% of children who entered out-of-home care in 2019 were under age 6 and 19% were under age 13
50.7% of children under age 1 who entered out-of-home care in 2019 had parental alcohol or drug abuse as an identified condition of removal4


Through federally- and foundation-funded projects, Children and Family Futures and its small business subsidiary, Center for Children and Family Futures, produces publications, reports, Technical Assistance tools and web-based learning for the field. The following are featured resources from our work. For more resources or information related to a specific topic, please visit our resources page or click the “Request Assistance” button below or at the top of the page.

  1. Behnke, M., & Smith, V. C. (2013). Prenatal substance abuse: Short- and long-term effects on the exposed fetus. American Academy of Pediatrics, Committee on Substance Abuse, Committee on Fetus and Newborn.
  2. U.S. Department of Health & Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. (2021). Child Maltreatment 2019. Available from
  3. U.S. Department of Health and Human Services. (2020). The AFCARS report: Preliminary FY 2019 estimates as of June 23, 2020 – No. 27.
  4. U.S. Department of Health and Human Services. (2020). The AFCARS report: Preliminary FY 2019 estimates as of June 23, 2020 – No. 27.